Benchmarking Public Sector Food Environment Policies in Iran: A Cross-Sectional Expert Assessment Study to Address...

Area of Science:

• Public Health Nutrition
• Health Policy Analysis
• Food Systems Research

Background:

• Iran confronts a significant public health challenge due to escalating rates of obesity and non-communicable diseases (NCDs).
• Effective, evidence-based policies are crucial for cultivating healthier food environments to combat these rising health issues.

Purpose of the Study:

• To conduct a comprehensive evaluation of national food environment policies and infrastructure in Iran.
• To benchmark these policies against international best practices using the Healthy Food Environment Policy Index (Food-EPI).
• To identify priority policy actions for addressing identified implementation gaps.

Main Methods:

• The Healthy Food Environment Policy Index (Food-EPI) tool was adapted and validated for the Iranian context.
• A systematic review of 89 government policy documents was performed.
• Thirty-nine national experts assessed 47 Food-EPI indicators across 13 domains using a 5-point scale, followed by qualitative content analysis for proposed actions.

Main Results:

• No policy indicators received a "high" implementation rating; most were "low" or "moderate."
• Highest scores were for food composition targets, front-of-pack labeling, and nutrient declarations.
• Significant weaknesses were identified in food promotion, retail regulation, food trade, governance, and transparency, though infrastructure support for monitoring was stronger.

Conclusions:

• This inaugural Food-EPI assessment in Iran highlights considerable scope for enhancing food environment policies and their implementation.
• The findings provide a strategic framework for Iranian policymakers to improve nutrition governance and reduce health inequities.
• Aligning national strategies with global best practices is essential for advancing the Sustainable Development Goals and improving population health outcomes.